Microsporidiosis secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Secondary prevention strategies following microsporidiosis include continuing treatment indefinitely after ocular microsporidiosis and continued HAART for HIV patients.

The following measures are effective for preventing recurrence:

• Treatment for ocular microsporidiosis should be continued indefinitely because recurrence or relapse might follow treatment discontinuation (BIII).^[1]
• Whether treatment can be safely discontinued after immune restoration with antiretroviral therapy (ART) is unknown, although it is reasonable, on the basis of the experience with discontinuation of secondary prophylaxis (chronic maintenance therapy) for other opportunistic infections during advanced HIV-1 disease, to discontinue chronic maintenance therapy if patients remain asymptomatic with regard to signs and symptoms of microsporidiosis and have a sustained (e.g. >6 months) increase in their CD4⁺ T lymphocyte counts to levels >200 cells/µL after ART (CIII).